Minimally Invasive Procedures

Procedures commonly offered by Newport Urologic Oncology



Transurethral resection of the prostate

The use of special scopes and special instruments to remove obstructive or abnormal tissue from the prostate and prostatic portion of the urethra. Can be performed using an Olympus bipolar device that potentially decreases blood loss and potentially limits some of the electrolyte issues that develop in some patients when the technology is not used. Furthermore, some prostates are larger and require longer surgery to trim out obstructive tissue. Bipolar technology allows for potentially longer surgery since fluid absorption of saline is less problematic than other irrigating fluids.



Photovaporization of the prostate

The use of special scopes and lasers to vaporize tissue from the prostate and prostatic portion of the urethra. This technology can potentially even be used in select patients who, due to certain medical conditions, are not able to stop blood thinners prior to surgery.



Button electrovaporization of the prostate

The use of special scopes and the Olympus button electrode to vaporize tissue from the prostate and prostatic portion of the urethra. The button electrode uses bipolar technology to vaporize tissue. It has been associated with less blood loss and less electrolyte abnormalities due to the type of irrigation fluid used. It also may allow for longer surgeries in the event of larger glands due to the decreased risk associated with absorption of saline as opposed to other irrigating fluids.



Transurethral resection of bladder tumor

Removal of a bladder tumor using special scopes and special instruments to remove abnormal tissue from the inside of the bladder which can then be sent to pathology for further evaluation. It is in essence a therapeutic and diagnostic procedure. The Olympus bipolar technology can be used for this type of procedure with benefits as previously discussed.



Transurethral incision of bladder neck contracture or urethral stricture

Use of special scopes and blades or lasers to open up abnormal scar tissue in the urethra which causes obstruction to urine flow (i.e. bladder neck contracture or urethral stricture). Patients typically have a catheter for a period of time after surgery to allow the urethra to heal in an open fashion.



Adrenalectomy

Adrenalectomy is the process of surgically removing an abnormal adrenal gland. We typically perform an adrenalectomy using robotic-assisted laparoscopic technology. However, we can also perform this procedure in a purely laparoscopic or open fashion.



Radical orchiectomy

Radical orchiectomy is the process of surgically removing an abnormal testicle when there is concern that cancer is present in the testicle. The testicle is typically removed via a groin incision as opposed to a scrotal incision to improve cancer control.



Retroperitoneal lymph node dissection

The surgical removal of lymph nodes from the retroperitoneum and pelvis in patients who have testicular cancer. However, this surgery can also be performed in patients who have other types of cancer (i.e. kidney cancer, ureteral cancer, other).



Radical Prostatectomy

The surgical removal of the prostate and seminal vesicles as a treatment of prostate cancer. We typically perform radical prostatectomy using robotic-assisted laparoscopic technology. However, we can also perform this procedure in an open fashion.



Radical Cystectomy

The surgical removal of the bladder as a treatment of bladder cancer.  However it can also be performed in other patients who have dysfunctional bladders or other cancers of the abdomen or pelvis involving the lower urinary tract.  In men it also includes removal of the prostate and seminal vesicles.  In women, it also includes removal of the uterus, fallopian tubes, and ovaries.  We typically perform radical cystectomy using robotic-assisted laparoscopic technology.  However, we can also perform this procedure in an open fashion.



Radical or Simple Nephrectomy

The surgical removal of the kidney as a treatment of kidney cancer. However, nephrectomy can also be performed for non-functional or poorly functional kidneys and is usually referred to as a simple nephrectomy when it is not being performed due to a diagnosis of cancer. We typically perform radical or simple nephrectomy using robotic-assisted laparoscopic technology. However, we can also perform this procedure in a purely laparoscopic or open fashion.



Partial Nephrectomy

The surgical removal of only a portion of the kidney due to either cancer or some other abnormal feature involving the kidney. Partial Nephrectomy has become a standard treatment option for select kidney lesions. Outcomes from partial nephrectomy have shown a similar ability in controlling cancer as compared to radical nephrectomy. However, partial nephrectomy has been associated with a decreased rate of kidney failure and as a result, less cardiovascular risk and decreased cardiovascular mortality as compared to radical nephrectomy. We typically perform partial nephrectomy in a robotic-assisted laparoscopic fashion. However, we can also perform this procedure in an open fashion.



Pyeloplasty

Surgical reconstruction of the upper portion of the ureter and renal pelvis. This surgery is typically performed due to obstruction of urine flow from the kidney to the bladder. We typically perform this surgical procedure in a robotic-assisted laparoscopic fashion. However, we can also perform this procedure in an open fashion.



Ureteral reimplantation

In an adult, this surgical procedure is typically performed due to an abnormality of the lower aspect of the ureter from obstruction (i.e. tumor, scar tissue) or traumatic injury of the lower ureter. Management usually requires removal of the abnormal portion of ureter and reimplantation of healthy ureter into the bladder.



Ileal conduit

An option for lower urinary tract reconstruction at times when the bladder is either surgically removed, or is severely dysfunctional.  It involves the use of a small portion of small intestine which is connected to the ureters draining the kidneys and traverses the abdominal wall as a conduit to allow drainage of urine from the end of the conduit into a bag worn on the abdominal wall known as a urostomy.



Indiana pouch

An option for lower urinary tract reconstruction at times when the bladder is either surgically removed, or is severely dysfunctional. Use of large and small intestine to create an internal pouch capable of storing urine. The pouch is attached to the ureters draining the kidneys and it is drained by passing a catheter through the stoma of a continent conduit of bowel traversing the abdominal wall.



Orthotopic neobladder

An option for lower urinary tract reconstruction at times when the bladder is either surgically removed, or is severely dysfunctional.  Use of small intestine to create an internal pouch capable of storing urine.  The pouch is attached to the ureters draining the kidneys and it is connected to the remaining portion of the urethra.  The urethral sphincter acts as the pouch’s continence mechanism.  Patients are typically able to urinate in the standard fashion.  However, some patients require catheterization of the pouch via the urethra due to difficulty in emptying the pouch.



Cystoscopy

Use of special scopes in the urethra or bladder for diagnostic purposes (i.e. identify a cause for a specific problem experienced by a patient) or treatment purposes (i.e. treatment of stones, bleeding, tumors, or other abnormal tissue in the lower urinary tract).



Uteroscopy

Use of special, small scopes in the ureter or renal pelvis for diagnostic purposes or treatment purposes (i.e. treatment of stones, bleeding, tumors, or abnormal tissue in the upper urinary tract).



Laser therapy

Lasers are frequently used in urologic surgery.  Different lasers are available for different types of surgical problems.  Lasers can be used to treat urinary tract stones, tumors, or enlarged obstructive prostate tissue.



Extracorporeal shockwave lithotripsy

A treatment for urinary tract stones using a non-invasive high intensity focused acoustic pulse which is directed using x-rays or ultrasound.

Available Procedures:

Transurethral resection of the prostate
Photovaporization of the prostate
Button electrovaporization of the prostate
Transurethral resection of bladder tumor
Transurethral incision of bladder neck contracture or urethral stricture
Adrenalectomy
Radical orchiectomy
Retroperitoneal lymph node dissection
Radical Prostatectomy
Radical Cystectomy
Radical or Simple Nephrectomy
Partial Nephrectomy
Pyeloplasty
Ureteral reimplantation
Ileal conduit
Indiana pouch
Orthotopic neobladder
Cystoscopy
Uteroscopy
Laser therapy
Extracorporeal shockwave lithotripsy

Robotic Surgeries Offered

  1. Robotic-assisted laparoscopic radical prostatectomy
  2. Robotic-assisted laparoscopic radical nephrectomy
  3. Robotic-assisted laparoscopic partial nephrectomy
  4. Robotic-assisted laparoscopic nephroureterectomy
  5. Robotic-assisted laparoscopic radical cystectomy
  6. Robotic-assisted laparoscopic pyeloplasty